Transplant Fellowship Training

Transplant Fellowships

The field of transplant surgery does not require an introduction. How one becomes a transplant surgeon following urological training, however, does need a bit of a clearification. Dr. Venkatesh Krishnamurthi, the transplant fellowship director at the Cleveland Clinic, was able to set the record straight.

Can a urologist train in ANY transplant fellowship or does it have to be in a Urological department?Venkatesh Krishnamurthi, MD: In general any urologist can train in any transplant fellowship, but the specific institutional requirements may preclude this. For example, some transplant fellows take General Surgery call -- this of course would not be feasible for a urologist. I did my transplant training at the University of Maryland with General/Transplant surgeons in 1999-2000. At that time I was the first urologist they trained and they accepted me and treated me as one of their own. Since then, they have trained at least 3 more urology graduates, including one of our Cleveland Clinic residents in 2006-2007.

Is there a list of programs that offer fellowships to urologists?Venkatesh Krishnamurthi, MD: No specific list. List of all fellowships and accredited organs can be found on ASTS website.

How many urology residents pursue a transplant fellowship each year?Venkatesh Krishnamurthi, MD: Hard to know this number but probably 1 or 2 per year. Our fellowship at the Cleveland Clinic has had at least 1 fellow per year for the last 25+ years, but during the last 10 years over 50% of the fellows did not do their urology training in the US or Canada. As you may know, urologists play a greater role in kidney transplantation in foreign countries. Unfortunately, transplant fellowships are relatively “un-competitive”. There are approximately 45 positions and only about 20 US and Canadian applicants (almost all general surgeons).

How does the selection process usually work?Venkatesh Krishnamurthi, MD: Prospective applicants should write or email. They can direct their inquiries to [program director] by either method. We would want them to come for an interview. Currently (summer 2008) we [at the Cleveland Clinic] are taking applicants for the 2010-2012 fellowship.

Comments by Dr. Krishnaamurthi, Program Director: Our fellowship training program is an American Society of Transplant Surgeons (ASTS) accredited fellowship in Kidney and Pancreas Transplantation that covers two clinical years of experience in kidney and pancreas transplantation. In general, we accept 1 (one) fellow per year; however, on occasion we may take 2 fellows in a single year. Our clinical programs perform approximately 150 kidney transplants and 30 pancreas transplants annually. Additionally, there is a robust experience in both laparoscopic donor nephrectomy and multiple organ procurement in the deceased donor. Lastly, although not a structured part of the fellowship or a requirement from the ASTS, there is ample experience in surgery for upper urinary tract oncology (open radical and partial nephrectomy, IVC thrombectomy and lap radical nephrectomy).